Active NPI
Amy Lucille Fustino, LCSW
- Mental Health Counselor
- Washington, DC
National Provider Identifier
1972377372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0904008371
- Practice address
- 909 New Jersey Ave SE Apt 801
Washington, DC 20003-5310 - Phone
- (716) 997-1903
- NPI assigned
- Nov 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0904008371 | VA | Primary |
Addresses
Primary practice location
909 New Jersey Ave SE Apt 801
Washington, DC 20003-5310
Mailing address
909 New Jersey Ave SE Apt 801
Washington, DC 20003-5310
Phone (716) 997-1903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904008371 | VA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699315200000",
"number": "1972377372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 NEW JERSEY AVE SE APT 801",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200035310",
"telephone_number": "716-997-1903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 NEW JERSEY AVE SE APT 801",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200035310",
"telephone_number": "716-997-1903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSTINO",
"first_name": "AMY",
"middle_name": "LUCILLE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-07",
"last_updated": "2023-11-07",
"certification_date": "2023-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0904008371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.